Hesperian Health Guides
The HIV testing process
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An HIV test is more than just the test itself. Good care means the person being tested:
- has counseling before and after the test. Counseling should include information about HIV infection, how HIV testing works, and why someone might need more than one test. Counseling before HIV testing may be done in a group.
- gives their permission to take the test and, if the person is a child, understands and agrees according to her age.
- has their privacy protected so no one will know about the test or the results except those the person wants to know.
- is asked about the support they have, such as a trusted friend or relative with whom they can discuss the results of the test.
A counselor can be both a teacher and a helper. By listening to and talking with people, counselors help people be better able to make their own choices and cope with problems and concerns.
Experienced counselors are able to give explanations, ask questions, and adjust their manner to fit the ages and needs of the adults or children they counsel. Good counseling will make you feel supported as you take an HIV test and learn the results.
Some HIV counselors know a lot about HIV and how to live with it because they have HIV themselves or have family members with HIV. Many health workers and caring community members have also studied and trained to counsel those who have HIV or worry they might.
A skilled HIV-testing counselor can support a person to:
- understand or decide to take an HIV test
- cope with feelings about the results of an HIV test.
- convince a reluctant partner to be tested and begin treatment if needed.
- decide who to tell about having HIV and how to tell them.
- talk with their children about HIV.
- learn where to get health care, medicines, and other support.
- meet others who have HIV or have children with HIV.
Some counselors even directly assist people in disclosing their HIV test result to their partners.
If you feel you are not ready to be tested or to have your child tested, the counselor or health worker may help you discuss your concerns. Ask the health worker what she thinks will happen to you or your child if you do not get tested now.
Understanding the test
Before doing an HIV test, a health worker should explain why the test is needed. If your child is being tested, you might also discuss what he knows about HIV.
The health worker should explain what kind of HIV test it is, and how quickly the result will be available. If possible, the health worker should explain how the test will be done. Children do better if they understand what is happening to them.
Younger children, up to about age 6, can understand that they may have an illness and a test will help them get the right treatment. Most school-age children, about 7 years and above, can understand more. See information on how to talk to different-aged children about the results of an HIV test.
Encourage children to ask questions by asking questions yourself, and help them ask their own questions. Children need different explanations depending on how old they are.
Remember you are the expert on your children, and what they can and cannot understand. Even in a busy clinic you and your child have the right to ask questions and know what is being done and why.
There are many ways to use multiple tests to make sure of a result, and the exact process differs in different countries or clinics. If you do not understand why an additional test is being done, ask.
Once your questions about the HIV test have been answered, whether the test is for yourself or for your child, the health worker or counselor should ask if you agree to have the test. If you agree, the health worker will do the test. Depending on local laws, children from birth to between 12 and 16 years old usually need a parent’s approval to be tested for HIV. If no guardian is present and the child needs health care, she can usually be tested. In most areas, young people age 16 or older can agree to HIV testing on their own.
You should have the right to say who can know about your test. Test results — and any other information about you and your health — should be confidential. Your health worker should not talk about you to anyone without your permission, except for another health worker when it is necessary for your care.
Often, health workers need training and support to better protect the privacy of the people they care for. Careful procedures can protect privacy by controlling who can see test results and other health records, and by how tests are labeled. Conditions in health facilities must make privacy and confidentiality possible, such as having spaces where others cannot see or hear counseling conversations.
Clinics and other programs that do HIV testing can also protect privacy by providing HIV testing along with other tests and care. Shared entrances and waiting rooms mean each person’s reason for being there is not obvious.
Many testing programs ask what support you have at home, especially when you go to be tested alone. A trusted friend or family member can give you strength to take a test, learn the results, and think about how to manage if you or your child has HIV. If you and your partner are willing, being tested at the same time means you can get information together and support each other. Some people want privacy at an HIV test, while others like to have someone they trust with them who can help ask questions or remember things.
Carefully choose people to talk with about the test result. People who would treat you or your child differently because of your HIV status are probably not the best people to tell first. Choose those who will listen, understand how you feel, and want to help. Another person who also has HIV, or who has children who have HIV, can help in many ways.
Where to get an HIV test
Many communities have HIV testing centers with trained counselors and people who can give HIV tests. If ART treatment is offered, doctors, nurses, pharmacists, and others may also be on staff. Sometimes support groups or post-test clubs for people with HIV meet at testing centers.
Testing for HIV can also be a normal part of health care for children and adults at clinics and hospitals. Children may be tested at immunization clinics, during regular mother and child health visits, or if they are hospitalized. Pregnant women can get an HIV test during a prenatal visit.
To make HIV testing easier and most available, some communities offer it with referrals to counseling at health fairs and other public events, by mobile outreach to remote areas, or by counselors going door-to-door to counsel and test people in their homes. You can also offer HIV testing at places like factories, schools, and churches, temples or mosques. The new HIV self-test can be purchased in pharmacies and used at home.